MEDICARE: NATALIE WALKER GOODIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	4325	KY

General Provider Information

NPI Number	:	1528305729
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIE WALKER GOODIN

Provider Business Mailing Address
First Line	:	4632 FAIRVUE FARM BLVD
Second Line	:
City	:	BOWLING GREEN
State	:	KY
Zip	:	42104-8302
Country	:	US
Telephone Number	:	270-634-4918
Fax Number	:

Provider Business Practice Location Address
First Line	:	4632 FAIRVUE FARM BLVD
Second Line	:
City	:	BOWLING GREEN
State	:	KY
Zip	:	42104-8302
Country	:	US
Telephone Number	:	270-634-4918
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2013
Last Update Date	:	06/22/2020

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Directions to “ NATALIE WALKER GOODIN ” Practice Location

Language	Start Address	Practice Location

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